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Oshkosh Public Library Application for Employment

Read Carefully Before Filling Out This Application

The application will remain in our files for 180 days as a record of the information which you give.

Any false statement knowingly made in this application or any deception or fraud on your part or on the part of any person acting on your behalf will be cause for eliminating you from consideration of or removal from library employment.

Answer all questions as completely as possible.

You are not required to furnish any information prohibited by federal, state or local law.

Personal Information

Position for which you are applying

Your Name

Date Available

Month

Day

Year

Today's Date

Month

Day

Year

Terms

Full Time

Summer

Part Time

Last Name

First Name

MI

Street Address

Apt. Number

City

State

Zip Code

Home Phone

Alternate Phone

E-mail

Are you a citizen of the U.S.?

Yes

No (If no, please explain your status)

Are you a citizen of the U.S.? No (If no, please explain your status)

Are you at least 16 years of age?

Yes

No

Your employment will be subject to verification that you meet state and federal minimum age requirements for the type of work you are applying for and have a valid work permit, if necessary.

Are any of your relatives or members of your family presently employed by the Oshkosh Public Library?

No

Yes (If yes, list name(s), relation, and department)

Are any of your relatives or members of your family presently employed by the Oshkosh Public Library? Yes (If yes, list name(s), relation, and department)

List the names of anyone you know employed at the library

Have you ever been employed by the Oshkosh Public Library?

Yes

No

Any other city, county or State of WI position?

No

Yes (If yes, in what capacity and during what period)

Any other city, county or State of WI position? Yes (If yes, in what capacity and during what period)

Reasons for leaving

Have you ever been convicted of a criminal offense other than a minor traffic violation?

No

Yes (If yes, give details)

Have you ever been convicted of a criminal offense other than a minor traffic violation? Yes (If yes, give details)

Availability

The Oshkosh Public Library is open all week. Check the boxes for times you would be available to work.

Hours

8 a.m. - 10 a.m.

10 a.m. - 12 p.m.

12 p.m. - 2 p.m.

2 p.m. - 4 p.m.

4 p.m. - 6 p.m.

6 p.m. - 8 p.m.

Monday

X

X

X

X

X

X

Tuesday

X

X

X

X

X

X

Wednesday

X

X

X

X

X

X

Thursday

X

X

X

X

X

X

Friday

X

X

X

X

X

X

Saturday

X

X

X

X

X

X

Sunday

X

X

X

X

X

X

Professional References

Give the names of three responsible persons, who are not related to you and who can recommend you as to personality, character, training and ability.

Name

Address

Telephone No

Name

Address

Telephone No

Name

Address

Telephone No

Education & Training

Name of School

Name of School and Location

Major/Degree

Did you graduate?

Presently attending?

Credits Earned

High School

College/Univ./Tech

College/Univ./Tech

Other

Employment History

Listing the most recent first, complete your employment record for your last two jobs:

From (month & year)

Title of position held

Phone Number

Last Salary

To (month & year)

Employer (Company Name)

Terms

Full Time

Part Time

Temporary

Hours each week

Address

Reason for leaving

Supervisor

Primary Duties

From (month & year)

Title of position held

Phone Number

Last Salary

To (month & year)

Employer (Company Name)

Terms

Full Time

Part Time

Temporary

Hours each week

Address

Reason for leaving

Supervisor

Primary Duties

May we refer to your present and previous employers?

Yes

No (If no, why not?)

May we refer to your present and previous employers? No (If no, why not?)

Specialized Training

Describe any specialized training, apprenticeship(s), skills and extra-curricular activities or military service that would qualify you to work at the library:

Specialized Training

By clicking on on the Submit Application button below, you declare that the foregoing statements are true, complete and correct to the best of your knowledge and belief. You understand and agree that any misstatements, omissions or falsification may result in disqualification or removal from a library position.